Hennepin Faculty Associates (HFA) is a network of over 250 conventional care physicians, staffing the Hennepin County Medical Center, a public multi-disciplinary health care campus in downtown Minneapolis. In 1993, after 10 years of research and limited service, HFA opened an Alternative Medicine Division and Clinic which, in 2000, served approximately 1200 individuals in more than 9000 patient-visits. Approximately 80% of the services provided at the Clinic are paid by 3rd party payers; over 75% of HFA physicians have referred patients to the clinic at least once. Patient data have been collected since opening in 1993, with total health care use and cost data available for some patients. The primary aim of the study is to analyze 8-year data collected at this integrated site to address questions relevant to establishing integrated health care delivery systems today. The secondary aim is to provide preliminary estimates and address feasibility concerns that will assist the design of future prospective studies to examine cost-avoidances that may be attributed to CAM therapies. Three sets of data and analyses are available. One set of analyses will compare health care uses and costs, from 1993 through 2001, for patients enrolled in a managed care plan who received treatment for pain, comparing outcomes for those who received acupuncture to those who did not, and matching by age, sex, education, date of diagnosis and severity of complaint. These analyses also will produce preliminary estimates of treatment effects (if they exist), variability, and necessary follow-up time to detect differences if they exist. These estimates may be used to design prospective trials investigating cost-offsets attributable to CAM. Additionally, the experience will address feasibility concerns related to conducting such trials. The second set of analyses will identify patient characteristics and types and severities of complaints that are associated with number of CAM patient-visits over time. The third set of analyses will identify physician characteristics associated with referring patients to an on-site CAM clinic, and how these patterns have changed in the past 5 years. The proposed project is in response to RFA AT-01-001: Integration of Complementary and Alternative Medicine: A Health Services Research Perspective. This RFA seeks to fund research that will facilitate integration of proven CAM therapies into the total health care delivery system in the U.S.